Intraocular device for dual incisions

Abstract

A microsurgical device and methods of its use can be used for treatment of various conditions including eye diseases, such as glaucoma, using minimally invasive surgical techniques. A dual-blade device can be used for cutting the trabecular meshwork (“TM”) in the eye. The device tip provides entry into the Schlemm's canal via its size (i.e., for example, 0.2-0.3 mm width) and configuration where a ramp elevates the TM away from the outer wall of the Schlemm's canal and guides the TM to first and second lateral elements for creating first and second incisions through the TM. The dimensions and configuration of the blade is such that an entire strip of TM is removed without leaving TM leaflets behind and without causing collateral damage to adjacent tissues.

What is claimed is: 
     
       1. A device for incising a trabecular meshwork, the device comprising:
 a platform for elevating a portion of the trabecular meshwork away from an outer wall of a Schlemm's canal, the platform comprising a tip at a distal side of the platform and a planar ramp extending from the distal side to a proximal side of the platform, opposite the distal side of the platform, wherein the ramp increases from a distal thickness at the distal side to a proximal thickness, greater than the distal thickness, at the proximal side; and 
 first and second lateral elements for creating first and second incisions through the trabecular meshwork, the first and second lateral elements (i) being separated by a gap having a width and (ii) extending from the proximal side of the platform; 
 wherein the platform further comprises a first side extending from the proximal side to the distal side and a second side extending from the proximal side to the distal side, the first side and the second side being configured to maintain an attachment of a portion of the trabecular meshwork across the ramp to adjacent portions of the trabecular meshwork on opposing sides of the ramp; 
 wherein proximal segments of the first side and the second side are parallel to each other and distal segments of the first side and the second side intersect at the tip. 
 
     
     
       2. The device of  claim 1 , wherein the first side and the second side each form a bevel of the platform. 
     
     
       3. The device of  claim 1 , wherein the first side and the second side each form a convex portion of the platform. 
     
     
       4. The device of  claim 1 , wherein the ramp increases from a distal width at the distal side to a proximal width, greater than the distal width, at the proximal side. 
     
     
       5. The device of  claim 1 , wherein a maximum width across the first and second lateral elements is not less than a maximum width across the ramp. 
     
     
       6. The device of  claim 1 , wherein the platform further comprises a bottom surface, opposite the planar ramp, that is planar or concave. 
     
     
       7. The device of  claim 6 , wherein the bottom surface has a maximum width that is less than a maximum width of the platform. 
     
     
       8. The device of  claim 1 , wherein the gap is defined by a wall between the first and second lateral elements and on a proximal side of the planar ramp. 
     
     
       9. A device for incising a trabecular meshwork, the device comprising:
 a platform for elevating a portion of the trabecular meshwork away from an outer wall of a Schlemm's canal, the platform comprising a tip at a distal side of the platform and a ramp extending from the distal side to a proximal side of the platform, opposite the distal side of the platform, wherein the ramp increases from a distal thickness at the distal side to a proximal thickness, greater than the distal thickness, at the proximal side; and 
 first and second lateral elements for creating first and second incisions through the trabecular meshwork, the first and second lateral elements extending from the proximal side of the platform; 
 wherein the platform further comprises a first side extending from the proximal side to the distal side and a second side extending from the proximal side to the distal side; 
 wherein proximal segments of the first side and the second side are parallel to each other and distal segments of the first side and the second side intersect at the tip. 
 
     
     
       10. The device of  claim 9 , wherein the first side and the second side each form a bevel of the platform. 
     
     
       11. The device of  claim 9 , wherein the first side and the second side each form a convex portion of the platform. 
     
     
       12. The device of  claim 9 , wherein the ramp increases from a distal width at the distal side to a proximal width, greater than the distal width, at the proximal side. 
     
     
       13. The device of  claim 9 , wherein a maximum width across the first and second lateral elements is not less than a maximum width across the ramp. 
     
     
       14. The device of  claim 9 , wherein the platform further comprises a bottom surface, opposite the ramp, that is planar or concave. 
     
     
       15. The device of  claim 14 , wherein the bottom surface has a maximum width that is less than a maximum width of the platform. 
     
     
       16. The device of  claim 9 , wherein the first and second lateral elements are separated by a gap defined by a wall between the first and second lateral elements and on a proximal side of the ramp.